What is insurance fraud, and how is it committed?

On Behalf of | Jul 13, 2022 | blog, Criminal Defense |

Being arrested for insurance fraud in Tennessee is terrifying. It’s important to know how this crime is committed and that you have the right to seek help.

What is insurance fraud?

Insurance fraud is a white-collar crime that can victimize anyone. It costs consumers billions of dollars each year by causing higher premiums. Just like other types of fraud crimes, the goal of a perpetrator is financial gain.

How is insurance fraud carried out?

Insurance fraud can take on many different forms. Some examples of the crime include the following:

  • A doctor bills an insurance company for medical services that were never provided to a patient.
  • A homeowner stages a break-in and makes a claim against their insurance company for valuable items they claim to be stolen.
  • An employee makes a workers’ compensation claim and reports that they suffered a back injury on the job but is actually not injured.
  • A person stages a slip and fall accident while visiting a resident of an apartment building to get a payout from that person’s insurance coverage.
  • A person underreports their income so they can qualify for Medicaid benefits.

Anyone can commit insurance fraud. This includes everyday people, doctors, lawyers or auto mechanics.

What are the elements of insurance fraud?

A person accused of insurance fraud can only be found guilty when the prosecutor proves that all the elements of the crime are in place. There must have been a false or misleading statement made with the intent to deceive. The statement must have been made in connection with payment, claims or applications. Finally, the statement must have affected the outcome of a claim or application.

Intent is a major factor in these cases. An honest mistake doesn’t constitute intentional insurance fraud.

If you face insurance fraud charges, you need a strong defense for your case.

Costner & Greene Attorneys at Law

315 High Street
Maryville, TN 37804




When you need legal help, we are here for you.